[104-10222-10042.pdf — page 127]
SECRET(When Filled In)# REPORT OF SERVICE ABROADTO: Office of Personnel, Transactions and Records Branch, Status Section| SERIAL NO. | LAST          | NAME      | MIDDLE || ---------- | ------------- | --------- | ------ ||            | (Print)       |           |        || 1-6        | 7-24          |           |        || 007667     | BUSTOS VIDELA | CHARLOTTE | Z      |INSTRUCTIONSUSE APPROPRIATE SPACE BELOW TO REPORT DATA FOR EITHER PCS OR TDY. INSERT APPROPRIATE CODE NUMBER IN "CODE" COLUMNTO DESIGNATE WHETHER SUBMISSION IS OF BASIC DATA, CORRECTION OR CANCELLATION (One only). REPORT DATES BY USINGTHE NUMBER FOR THE MONTH AND LAST TWO DIGITS ONLY FOR YEAR. REFER TO OFI NO. 80. REVISED.FCS DATES OF SERVICE| ARRIVAL O/S | DEPARTURE O/S | TYPE OF DATA | CODE  | O/P USE ONLY | COUNTRY | CODE                                         |     |       |        |       || ----------- | ------------- | ------------ | ----- | ------------ | ------- | -------------------------------------------- | --- | ----- | ------ | ----- || MONTH       | DAY           | YEAR         | MONTH | DAY          | YEAR    |                                              |     |       |        |       || 25-26       | 27-28         | 29-30        | 31-32 | 33-34        | 35-36   |                                              | 37  | 38 39 |        | 40-42 || 07          | 28            | 67           |       |              |         | 1. PCS (Basic) 2. CORRECTION 3. CANCELLATION | 1   |       | MEXICO | 50    |TDY DATES OF SERVICE| ARRIVAL O/S | DEPARTURE O/S | TYPE OF DATA | CODE  | O/P USE ONLY | AREA(S) | CODE                                         |     |       |     |       || ----------- | ------------- | ------------ | ----- | ------------ | ------- | -------------------------------------------- | --- | ----- | --- | ----- || MONTH       | DAY           | YEAR         | MONTH | DAY          | YEAR    |                                              |     |       |     |       || 25-26       | 27-28         | 29-30        | 31-32 | 33-34        | 35-36   |                                              | 37  | 38 39 |     | 40-42 ||             |               |              |       |              |         | 2. TDY (Basic) 4. CORRECTION 5. CANCELLATION |     |       |     |       |OFFICE OF PERSONNEL USE ONLY - PUNCH AREASOURCE DOCUMENT AND CERTIFICATIONTRAVEL VOUCHER DISPATCHCABLE X DUTY STATUS OR TIME AND ATTENDANCE REPORTOTHER (Specify)DOCUMENT IDENTIFICATION NO. DOCUMENT DATE/PERIODFORM 764 2 - 29 JULY 1967REMARKSARRIVAL DATE REPORTED UNDER "OTHER REMARKS" ON DUTY STATUS REPORT.|     | PREPARED BY           | REPORT ANNOTATED AS CONTROL DOCUMENT | ABOVE DATA CERTIFIED CORRECT, BASED UPON SOURCE DOCUMENT CITED || --- | --------------------- | ------------------------------------ | -------------------------------------------------------------- ||     | CCC                   | X                                    |                                                                ||     | C & L DIVISION, CTRS. | DATE                                 | SIGNATURE                                                      || X   | S & T DIVISION        | 16 APR 1968                          | *illegible signature*                                          |THIS REPORT WILL BE FILED IN THE OFFICE OF PERSONNELIN THE INDIVIDUAL'S OFFICIAL PERSONNEL FOLDERFORM 1451a OBSOLETE PREVIOUS2-67 EDITIONS (14-10)SECRET